2020- 2021 KIS Bunrang Registration

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Please fill out this form to sign up for the Knoxville Irish Society's Beginner Level(Bunrang) Irish Language Course.

Name of Student (First, Last) *

Mailing Address *

Please provide a valid mailing address.

Email Address *

Primary phone *

Please indicate Mobile/Home/Work/Other and include area code.

Are you a member of KIS? *

To take the class, you must first be a member of the Knoxville Irish Society. If not, please go to http://www.knoxvilleirish.com/join.html to join.

Yes

KIS email list choices *

Joining the "Irish language class" email list is strongly recommended. You would probably also like to get email notices and reminders of other events hosted by the Knoxville Irish Society. In which case, be sure to also check the "News & Events" box too. If you would like to volunteer any amount of time to help make KIS events successful, we would be most grateful. The form to join the Knoxville Irish Society provides these same options. You may choose however many you want, and there's always the option to unsubscribe.

Please add me to the "Gaelic class" email list (strongly recommended).

Please add me to the KIS "News & Events" list (recommended).

I am interested in volunteering with the Knoxville Irish Society.

I am currently signed up to one or more of the KIS email lists.

Required

Please choose one of the following: *

I am at least 18 years of age.

I am under 18 and have my parent or legal guardian's permission to participate in this course.

I am under 18 and do not have my parent or legal guardian's permission to participate in this course.

I have a different situation than those above and would like to speak with the instructor.

I confirm that I have read all available KIS-produced information regarding the above class and I am willing to commit to a year of study in order to graduate. I also confirm that I will not hold the class instructor, the Knoxville Irish Society (KIS) or KIS officers liable for any damage, injury or, loss (physical or otherwise) sustained while participating in the class. *

Please print name below.

Comments, questions, or concerns for the instructor:

You will receive an email response at the address you provide above. If you would prefer a phone call, please mention that. KIS looks forward to helping you succeed in this class!

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